Drugs and Pacemakers in Patients with Atrial Fibrillation and Heart Failure

Abstract

Atrial fibrillation (AF) is a common arrhythmia: its incidence increases markedly with age and it is frequently associated with heart failure (HF) [1]. In patients with HF the incidence of AF is estimated at between 20% and 40%.HF gives rise to electrophysiologic and hemodynamic changes in atrial tissue that favor the onset and maintenance of atrial fibrillation: sympathetic tone, increased pressure, wall-stretching, and mitral regurgitation. On the other hand, the onset of AF in patients with HF often leads to a marked worsening of the clinical condition of these patients: loss of atrial systole, high and irregular ventricular rate, mitral regurgitation, low coronary and cerebral flow, and so on.